Professor Cecily Begley

Chair of Nursing & Midwifery (School of Nursing & Midwifery)

DOLIER STREET - SCHOOL OF NURSING

Prof. Cecily Begley holds the Chair of Nursing and Midwifery in Trinity College Dublin. She was awarded MA, MSc and PhD degrees from Trinity College, and the Fellowship of the Faculty of Nursing from the Royal College of Surgeons in Ireland. She was a Fellow of the European Academy of Nursing Science and is an elected Fellow of Trinity College Dublin. Following four years' experience in general nursing, and 12 years in midwifery, she spent 8 years as a lecturer/senior lecturer at the Faculty of Nursing in the Royal College of Surgeons in Ireland. In 1996, she took up the post of Director of the School of Nursing and Midwifery in Trinity College, charged with the task of developing the new School. Twenty years later, this School now runs 18 undergraduate and postgraduate programmes, with 1400 students and over 100 staff, and has a strong research programme. Prof. Begley is active in developing educational initiatives at undergraduate, postgraduate and post-registration level in Ireland. She was appointed a member of the Nursing Education Forum set up by the Minister for Health and Children to plan and implement the 4-year BSc Nursing degree programme. She subsequently served on the National Implementation Committee that oversaw the introduction of the degree throughout Ireland in October 2002. She also served as a member of the Expert Group on Midwifery and Children's Nurse Education set up to plan the two direct-entry degree programmes, and on the National Implementation Group that ensured their commencement nation-wide in October 2006. Prof Begley was a member of the National Council for Professional Development of Nursing and Midwifery in Ireland for the first five years of its existence, and worked on the sub-group for Educational Standards for Advanced Nurse and Advanced Midwife Practitioners. In terms of educational development overseas, Prof Begley led a team from the School, in collaboration with Queen's University, Belfast, in providing academic consultancy services to Jordan University of Science and Technology to assist them in developing and modernising their MScs in Adult Health Nursing and Critical Care Nursing, and in developing a new MSc in Maternal and Child Health. This partnership was awarded 487,000 from the EU TEMPUS project to support the initiative. Prof. Begley has led many research teams to successful completion of diverse projects, focusing mainly on physiological childbirth, women-centred maternity care, care of women with disabilities, advanced and specialist practice and self-esteem and assertiveness in student nurses and midwives. Her research-based commitments include the supervision of 6 PhD students at present, 23 PhD and 4 MSc by research students to successful completion in the past 8 years, and external examining of 15 research MSc/PhD theses from diverse countries. She has been successful in obtaining over 7,000,000 in research funding, as PI or collaborator, and holds/has held a total of 26 grants from the HRB, NDA, HSE Western Area, HSE North-Eastern Area, National Council for the Professional Development of Nursing and Midwifery in Ireland, the European Science Foundation and the EU Commission (FP7 Framework). She is a member of the Meath Foundation Research Review Committee, previously served for 8 years on a research review committee for the Health Research Board, is an invited member of the International Confederation of Midwives' Research Advisory Network and is a member of the ESF Pool of Reviewers for the period of 01 May 2010 to date. She is a Section Editor for the BMC Pregnancy and Childbirth journal, has editorial and/or reviewing commitments for 4 other medical, nursing, or midwifery journals and has published widely on nursing and midwifery clinical and education issues.

Concern has been expressed globally at rising caesarean section (CS) rates with a lack of evidence of any associated decrease in morbidity for mothers and babies, indicating that many CSs are unnecessary. Maternal mortality and severe morbidity are doubled following CS compared with vaginal birth, and neonatal respiratory distress requiring oxygen is 2-7 times more common. CS costs 739 (elective) or 1180 (emergency) more than vaginal birth. This research team have just completed testing an intervention in Ireland, Germany and Italy ("OptiBIRTH") designed to increase vaginal birth after caesarean section (VBAC), thus reducing repeat CS in women who had CS before. Applying such knowledge to develop a similar intervention designed to reduce the number of unnecessary CSs in Europe would have health benefits for mothers and babies. Aim: To develop and pilot an intervention designed to reduce overall CS rates from approximately 34% to 27%, and to test the feasibility of a larger, pan-European trial. A pilot cluster randomised trial (CRCT) will be used to test an intervention designed to reduce overall CS rates in all women. This intervention will be adapted from the "OptiBIRTH" intervention, using information from systematic reviews of trials, and evidence-based national guidelines, aimed at reducing CS rates, and 8 focus group interviews (FGIs) with women, their partners and clinicians. Following ethical approval, two maternity units in Dublin will be randomly allocated to receive either the intervention or usual practice, and 300-400 consenting women in each unit will be recruited. Primary outcome is CS rate; other outcomes include interventions, change in women and clinicians' attitudes to CS/vaginal birth, fear of birth in women, and maternal/neonatal morbidities up to 6 months. Mother and baby data will be collected using self-completion surveys in pregnancy and at 3-&6-months' postnatal, and from hospital records. Surveys have been tested for validity and reliability in a large cohort study in Ireland (MAMMI study). Cost data will be collected to test the tool proposed for use in the pan-European cluster randomised trial. Analysis of FGIs will use Constant Comparative Analysis methods. Quantitative data will be analysed by 'intention-to-treat' using inferential statistics.

As maternal mortality decreases, maternal morbidity becomes even more important as an indicator of quality care. Reported postnatal morbidities include backache, tiredness, urinary (UI) and faecal incontinence, dyspareunia, depression and increased risk of readmission with wound infection following caesarean section. The MAMMI study (Maternal health And Maternal Morbidity in Ireland), Phases 1+2, has recruited 2,800 primiparous women from three maternity hospitals, aged 18 years+. Participants complete questionnaires about their health before and during pregnancy, and at 3, 6, 9 and 12 months afterwards. The extension into this third phase, MAMMI-SIM involves: . Second baby survey . Intervention for women with urinary incontinence . Measuring costs of morbidity to women and services. Aim To build and attract capacity into the area of maternal health and health-services research at postdoctoral level in Ireland. This will be achieved by: . developing a partnership between six experienced principal research investigators in differing fields, and clinicians, consumers and decision-makers in the field of maternity care. . forming a strong, interdisciplinary maternal health research team that will guide, teach and support 3 post-doctoral researchers (biostatistics, midwifery, health economics) to develop skills and competencies required for successful interdisciplinary and trans-sectoral health-services research. . following-up the MAMMI cohort to ascertain levels of morbidity following second birth (n=1600) (IF-1, biostatistics). . developing, and testing for feasibility/acceptability, an intervention for women experiencing UI, and preparing a funding proposal for a trial to test the intervention (IF-2, midwifery). . assessing costs of postnatal morbidity to the health-service and women (IF-3, health economics) . disseminating findings effectively, to influence policy and practice in Ireland, and submitting interdisciplinary funding proposals in maternal health area. Results of MAMMI-SIM will ascertain which women in future might need different care, or more support, intervention or treatment following birth, and costs of such care, from which improvements in maternity services can be implemented.

Member of the Meath Foundation (Tallaght Hospital) Review Panel for Health Research

Feb 2002 to date

Member of the Nursing Education Forum. Elected chairperson of two sub-committees

Jan 1999 to Oct 2001

Member of the National Implementation Committee set up by the Minister for Health and Children to monitor the implementation of the Nursing Education Forum's Report

Feb. 2001 to Dec 2002

Member of the Expert group in Midwifery and Paediatric Education set up by the Minister for Health and Children

Sept 04-Jan 05

Member of An Bord Altranais' Continuing Education Committee. Member of the Research Steering Committee that undertook the study of continuing education in nursing in Ireland

1994 to 1997

Member of the National Council for the Professional Development of Nursing and Midwifery in Ireland

Jan 2000 to March 2005

Member of the Steering Committee for the Dementia Services Information and Development Centre, St. James' Hospital

1998 to October 2005

Member of the Midwifery Sub-Committee of An Bord Altranais

1998 to 2001

Member of the National Midwifery Advisory Forum set up by the Department of Health and Children

Sept 2000 Jan 2002

Member of the Joint North-South Forum for Planning the Public Health Nursing Services

1998 to 2003

Member of the Cancer Consortium Nurses' Working group, formed between the Department of Health and Children, Ireland, the Department of Health, Social Services and Public Safety, Northern Ireland and the National Cancer Institute, Washington

Jan 2001 to Oct 2005

Member of the Medical Committee of the Irish Cancer Society.

February 2002 to October 2005

Member of the Prescribing Project for Nurses and Midwives and to Member of the Education Sub-Committee of that group

April 2002 to 2005

Member of the Dept. of Health Steering Committee for the Research Study into Manpower Planning

Begley C. M., Brady A-M, Byrne G, Macgregor C, Griffiths C, Horan P, A Study of the Role and Workload of the Public Health Nurse in the Galway Community Care Area , Dublin, School of Nursing and Midwifery Studies, Trinity College, Dublin , 2004,
Report,
PUBLISHED

Begley, C., Brady, A-M. Byrne, Macgregor, C., G, Griffiths, C.& Horan, P. , A Study of the Role and Workload of the Public Health Nurse in the Galway Community Care Area, Dublin, Trinity College:, 2004,
Report,
PUBLISHED